Keep Friends Close

Friendships can and should be preserved and encouraged for people with Alzheimer’s.

By Winnie Yu

When Carol Bradley Bursack’s father developed dementia, friends and former colleagues slowly stopped visiting. The loss of the friendships saddened her father, a former supervisor in the local sanitation department, who had been popular and well liked by his staff.

“I ran into a couple of the men who worked under him throughout the years and they’d get teary talking about Dad,” recalls Bursack, author of Minding Our Elders: Caregivers Share Their Personal Stories. “They couldn’t take seeing him like that. He and Mom also had a nice circle of friends. Toward the end, only one couple came to visit. I never blamed them. But I knew how much it would have meant to Dad had they visited.”

The Need for Friends

It’s not uncommon for the onset of dementia to result in the loss of long-time friendships. Conversations that once flowed easily can become confused and disjointed. Shared activities become increasingly difficult, and spending time with someone who doesn’t recognize you can be sad. But like anyone else, people with Alzheimer’s need friends and social contacts in general. Interacting with others helps people with dementia feel connected, and lets them know they still matter.

“Human beings are essentially social and this is true regardless of age or cognitive status,” said Susan McFadden, Ph.D., co-author of Aging Together: Dementia, Friendship, and Flourishing Communities. McFadden points out that all people need mutual relationships of trust and caring. It’s important for physical, mental and spiritual well-being. “Unfortunately, when some people receive the diagnosis of dementia, their friends sometimes retreat, whether out of fear or uncertainty, and have difficulty knowing how to remain in a relationship with an individual who may no longer remember the story of the friendship.”

Sustaining Friendships

Caregivers can help keep friendships intact by nurturing these relationships and letting friends know how much they’re needed. Sustaining these friendships begins with identifying the people who are most likely to commit to the friendship. “They may be new friends or long-time friends, but they share an attitude of compassion and caring along with the willingness to learn new ways to relate to a friend,” Bursack says.

Here are some ways caregivers can help prepare friends of those with Alzheimer’s:

McFadden encourages friends to understand that dementia is a progressive condition and that they will need to be flexible in relating to the person as changes occur. In the early stages, for instance, the changes are often not obvious. But as time passes, the person’s personality and behaviors will change, and it may be more challenging to do simple tasks. Over time, they may also lose language skills that can make communication more difficult.

Coach friends on how to communicate.

Explain the importance of validating what the person with the disease says, and do your best to let the person with Alzheimer’s lead the conversation. Suggest that friends bring photos from the past or tell stories. But don’t ask the person with Alzheimer’s to recall an event or argue with him about facts. Many people with Alzheimer’s can’t recall details and facts, and may struggle to remember an event, which will cause frustration and anxiety for them, and further exacerbate social withdrawal.

Also, encourage visitors to announce themselves when they come into the room. Don’t assume that the person with Alzheimer’s will always recognize them. Make sure friends understand that even if the person with dementia doesn’t immediately recognize them, their presence is still valuable.

Urge them to keep the conversation lighthearted and in the moment.

Avoid asking for information that people with Alzheimer’s can no longer recall, such as what they had for breakfast or whether they remember an event from the past. Instead, try talking about something in the here and now, such as the weather or an activity you’re doing during the visit. Look for humor whenever possible.

McFadden says many people wonder what to talk about with a friend who no can longer engage in a coherent, linear conversation. Once this change is accepted, there can be marvelous, imaginative conversations that give joy to both parties. She recommends the TimeSlips Creativity Journal (www.attainmentcompany.com/timeslips-creativity-journal) as a great resource to help friends have these kinds of conversations.

Remind visitors that it’s their presence that counts, not the quality of the conversation or the duration of the visit.

Urge them not to get upset if their friend or family member forgets about a recent get-together. Remind them that the visit was enjoyed while it happened. Perhaps most important, Bursack says, is to “reassure visitors that it’s not their fault if the person they are visiting reacts negatively to them or to something that they say.” Try to keep in mind that it’s the disease responding, not the person, she says.

Find new ways for friends to relate to your loved one.

Let friends know that people with dementia still need visitors, even if they sleep much of the time. “It doesn’t have to be hard,” Bursack says. “Touch them. Speak in a loving voice. Spend some time watching TV together. Remember that this could be you and do what you’d want done for you.”

Say thank you.

Be sure to express your gratitude for those friends who do stick around. It’s not easy to watch a friend change and develop dementia. Those who do are true friends who deserve your appreciation.